1. Field of the Invention
The present invention relates to a total enteral nutritious composition that can efficiently supply proteins, fats, sugars, vitamins and minerals to those in need of nutritional supplementation, such as the elderly or inpatients.
2. Related Background Art
Concerns have been raised in recent years regarding the deteriorating nutritional state of elderly inpatients and the elderly cared for at home. A malnutritional state characterized by protein and energy deficiency is known as Protein Energy Malnutrition (PEM), and the importance of effective nutritional supplementation for this state is well recognized. In “Study of Nutritional Management Services for the Elderly” for 1995-1998 (1999 Health and Welfare Ministry Report, Matsuda, A. et al.), it was observed that individuals at risk of PEM, having serum levels of below 3.5 g/dL for the nutritional index albumin, consisted of approximately 40% elderly inpatients and approximately 30% home cared patients. A lack of sufficient protein and energy due to reduced dietary intake or the like can produce a serious malnutritional state, resulting in immune depression-related infection, loss of muscular strength and a bedridden state, and leading to extended hospitalization and increased medical costs. A bedridden condition often causes bedsores, of which contributing factors include lack of energy, insufficient protein intake, impaired biosynthesis of protein, reduced fat intake and lack of trace elements such as zinc (Rinsho Eiyo: Vol. 103, No. 4, pp. 424-431, 2003). Some factors characteristically contributing to elderly bedsores include multiple complications such as angiopathy, anorexia, and immune impairment due to malnutrition (Rinsho Eiyo: Vol. 103, No. 4, pp. 424-431, 2003).
An oral nutritious composition comprehensively comprising proteins, fats, sugars, vitamins and minerals for individuals requiring nutritional supplementation is known (Japanese Patent Publication No. 3102645). The nutritious composition alone can provide nutritional management, and it is characterized by containing milk protein and soybean protein in a specific proportion among the protein materials in the composition, as well as containing ω-3 fatty acids and ω-6 fatty acids in a specific ratio among the fats. There is also known a total enteral nutrient preparation comprising proteins, fats, sugars, an emulsifier and water, which has a specified osmotic pressure and amino acid score (Japanese Patent Laid-open (Kokai) Publication No. 2004-51494).
The elderly and patients suffering considerable malnutrition have lower gastric volume, which limits the amount of food that can be ingested. Such individuals require enteral nutritious compositions with high caloric content per consumption volume, an optimal balance of nutrients and high concentrations of components such as vitamins and minerals. Enteral nutritious compositions with 100 kcal per 100 mL are available on the market, and demand is expected to further increase in the future.
At the current time, however, no enteral nutrient preparation is known that improves serum levels of the nutritional index albumin, maintains suitable blood levels of copper, zinc and sodium and has an ameliorating effect on bedsores. Moreover, from the comprehensive viewpoint of incorporating highly purified proteins and fats and including an appropriate dosage of vitamins to facilitate energy production in the body, no total enteral nutritious composition has yet been provided that comprises an appropriate formulation of these essential components. For example, merely increasing the sodium content of a protein-rich nutritious composition has been a limited strategy due to protein precipitation (salting out). However, since some elderly suffer from hyponatremia, it is very important to increase the sodium content with protein content in high-energy total enteral nutritious compositions.    [Patent document 1] Japanese Patent Publication No. 3102645    [Patent document 2] Japanese Patent Laid-open (Kokai) Publication No. 2004-51494